What is Minimally Invasive Surgery?

Minimally invasive surgery, popularly known as "keyhole surgery", is a modern philosophy of patient care. With the integrated endosuites capable of robotic videoscopic surgery and monitor, a fine viewing instrument is inserted through a small incision or natural orifice (such as the mouth, anus and navel) to manoeuvre and treat or remove the diseased organ, instead of opening up a big incision on the body wall.

Minimally invasive surgery has set a new standard for the operative management of a wide variety of diseases across various surgical disciplines. The basic principles of operation, however, remain the same as in conventional surgery.

Advantages of Minimally Invasive Surgery
  • Reduces blood loss and postoperative pain
  • Cosmetically better because of smaller scars
  • Reduces surgical trauma and chance of wound infection
  • Minimizes operation induced impairment to the body's immune system
  • Accelerates recovery and reduces hospital stay
  • Much smaller incision scars
Application of Minimally Invasive Surgery
  • Ear, Nose and Throat Surgery

    MIS techniques are widely used in the field of Ear, Nose and Throat, and Head and Neck Surgery. Fiberoptic and rigid endoscopes, surgical microscopes and lasers allow many diagnostic and therapeutic procedures in the head and neck to be performed through the ear, nose and mouth, thus eliminating the need for an external incision on the patients face. A recent development is the avoidance of neck incisions for lesions including the thyroid in the neck. Examples of surgeries in the field include:

    • Functional Microsurgery of the Ear and Cochlear Implantation (** Conductive and Congenital Hearing Loss
    • Oropharyngeal and Laryngeal Laser Surgery (** Oropharyngeal or Laryngeal Diseases)
    • Functional Endoscopic Sinus Surgery (** Sinusitis)
    • Endoscopic Dacrocystorhinostomy (** Lacrimal Duct Blockage)
    • Endoscopic Thyroid Surgery (** Thyroid Tumor)

    ** - Target Disease


  • General Surgery

    Common endoscopic surgeries:

    • Colonoscopy Instruction and Information
    • OGD Instruction and Information
    • Cholecystectomy (**Cholecystitis)
    • Appendicectomy (**Appendicitis)
    • Gastrectomy (**Stomach Cancer)
    • Herniorrhaphy (**Hernia)
    • Colectomy (** Colon Cancer )

    ** - Target Disease



  • Gynaecological Surgery

    Hysteroscopy and laparoscopy are widely applied in diagnosing and treating a full range of gynaecological diseases. They are well accepted by female patients because of the effectiveness, accuracy and minimal scarring thus having better satisfaction. For details of gynaecological services, please click here.

  • Neurosurgery (Brain & Spine)

    A full range of highly specialized services for diseases of the brain and spine are provided for both adults and children with the incorporation of minimally invasive management strategies including microsurgery, endoscopic surgery and navigation guided brain surgery. They are recommended for the management of brain tumours, brain haemorrhage, ischaemic stroke, hydrocephalus, spine diseases due to degeneration, trauma, haemorrhage or tumor. The operations include:

  • Orthopaedic Surgery

    Common arthroscopic surgeries :

    • Knee Surgeries
      • Anterior cruciate ligament reconstruction (**Anterior cruciate ligament injury)
      • Meniscectomy or meniscal repair (**Meniscal tear)
      • Removal of loose bodies or osteophytes (**Loose bodies and osteophytes)
    • Shoulder Surgeries
      • Bankart repair (**Recurrent dislocation of shoulder)
      • Arthroscopic subacromial decompression (**Impingement syndrome)
      • Rotator cuff repair (**Rotator cuff tear)
      • Manipulation under anaesthesia + arthroscopic release (**Frozen shoulder)

    Union Hospital will provide the following surgery services from 1 July 2008:

    • Diagnosis
      • Wrist pain diagnosis & repair
    • Hand & Wrist Surgery
      • Acute carpal fracture
      • Bone graft for carpal nonunion
      • Rheumatoid & other synovectomy
    • Spine Surgery
      • Microscopic lumbar disc resection
      • Microscopic decompression for spinal canal stenosis
      • Posterior dynamic stabilization device implantation
      • Interbody fusion & vertebroplasty
      • Therapeutic injection for back pain
    • Others
      • Other joints like ankle, elbow and wrist are amendable for arthroscopic surgery.
      • Percutaneous implant fixation of fractures

    ** - Target Disease

  • Paediatric Surgery and Paediatric Urological Surgery

    Over 90% of common surgical operations in infants and children that are traditionally performed via an open approach can now be performed very safely and effectively by minimally invasive surgery approach. These range from the most simple surgery like herniotomy for inguinal hernia and appendectomy for acute appendicitis to complicated procedures including laparoscopic primary pullthrough for Hirschspring's disease, excision of choledochal cyst with hepaticoenterostomy, to various types of complex bladder surgery. Children could benefit more from these minimally invasive therapy with much less pain & discomfort, as well as shorter hospital stay that alleviates separation anxiety, and quicker return to normal school activities. The surgeries include:

    • Laparoscopic Hernia Repair (**Hernia)
    • Laparoscopic Fundoplication (** Gastroesophageal Reflux)
    • Pneumovesical Ureteric Reimplantation (**Vesicoureteric Reflux)
    • Laparoscopic Primary Pullthrough for Hirschsprung's Disease (** Hirschsprung's Disease)
    • Excision of Choledochal Cyst with Hepaticoenterostomy (** Choledochal Cyst)

    ** - Target Disease

  • Thoracic Surgery

    Traditional chest operation incurs an incision scars extremely large and long incision curving around the chest from the back to the front. In addition, major chest wall muscles have to be divided and ribs have to be widely spread in order to gain access into the chest. Patients having this operation suffer from severe wound pain, slow recovery and frequent postoperative complications such as persisting pain even after the wound has healed. With the development of advances in minimally invasive video-assisted thoracoscopic surgery, the quality of patient care is greatly improved with reduced trauma, less post-operative pain and shorter recovery. It is widely used in:

    • VATS Sympathectomy (**Sweaty Palms)
    • VATS Lobectomy (**Lung Cancer)
    • VATS Pleurodesis (**Pneumothorax)
    • VATS Lung Volume Reduction (**Emphysema)

    * VATS - Video Assisted Thoracic Surgery

    ** - Target Disease

  • Urological Surgery
    • Benign Prostatic Hyperlasia
    • Tumour
      • Superficial bladder cancer
      • Prostate cancer
    • Stone
    • Male Genital Mutilation
    • Male Genital Mutilation
      • Undescended Testis
      • Varicocele
      • Erectile Dysfunction
      • Penile Currature
    • MIS Urological Surgery

Emphysema Urology
Fractures Hepatitis B
Intussusception Endoscopy
Appendectomy Rheumatology
Joint dislocation Laparoscopic
Joint replacement Colonoscopy
Cruciate ligament Varicose vein
Endoscopic thoracic
Cooled radiofrequency
Benign prostate hypertrophy
Systemic lupus erythematosus